


The Tribunal of Lieutenant Commander Leonard H. McCoy, MD PhD

by doctormccoy



Category: Star Trek, Star Trek: Alternate Original Series (Movies)
Genre: Angst, Brief Sexual Content, Established Relationship, Illness and Diagnosis, Leonard "The H Stands For Horrendous Martyr" McCoy, M/M, Medical stuff, Military/Wrongful Death Tribunal, Minor Character Death, Multi, Not Star Trek: Boldly Go Canon Compliant, Playing fast and loose with medical canon, Post-Star Trek Beyond
Language: English
Status: Completed
Published: 2017-10-02
Updated: 2017-10-02
Packaged: 2019-01-07 19:51:21
Rating: Mature
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 3,579
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/12239544
Author URL: https://archiveofourown.org/users/doctormccoy/pseuds/doctormccoy
Summary: “So, Lieutenant Commander McCoy. As I’m sure you are well aware, we have convened this Tribunal to assess whether you are responsible for the events surrounding the spread of Syndrome A, now known as Choriocytosis, and the deaths of five of your patients as a result of any potential negligence on your behalf.”





	The Tribunal of Lieutenant Commander Leonard H. McCoy, MD PhD

**Author's Note:**

  * For [camshaft22](https://archiveofourown.org/users/camshaft22/gifts).



> A commission fic delivery for [camshaft22](http://camshaft22.tumblr.com/). 
> 
> A fic where the title/summary isn't a poem quote or song lyric? I'm as shocked as you are.

“So, Lieutenant Commander McCoy. As I’m sure you are well aware, we have convened this Tribunal to assess whether you are responsible for the events surrounding the spread of Syndrome A, now known as Choriocytosis, and the deaths of five of your patients as a result of any potential negligence on your behalf.”

McCoy stands stiffly at parade rest, fingers clenched into fight fists behind his back. His expression is grim and resigned as if he already expects damnation without so much as a how do you do. Instead, he’s instructed to take his seat while the panel of hologram Starfleet brass considers the paperwork before them. 

“Bring us back to the beginning, then. When did this all start?” the crisp, commanding voice of Admiral Nogura echoes around the room, stuffed to the brim with crew members of the Enterprise, the command staff of the Yorktown, and anyone else who had managed to get inside the overcrowded space before the doors swung shut. 

Heaving a silent sigh, McCoy closes his eyes, collecting his thoughts and attempting to settle his nerves. Anger and frustration buzz just below the surface, making him itch with the desire to lose his temper, however illogical and ill advised it would be in current company. 

“It all started a month ago when Ensign Jabil Connors came to see me,” he eventually begins, recalling the memory to the forefront of his mind. 

It had been a regular day for McCoy. He’d taken a posting at Yorktown General Hospital following the thwarting of Krall’s attack on the goddamned snowglobe. It’d be months before the Enterprise would be finished and ship shape for space exploration, and the idea of having that much down time made Leonard’s skin crawl all over. Other members of the Enterprise crew had taken jobs in a wide variety of sectors, eager to pull their own weight and desperate for anything to keep them busy.

McCoy had written a lot of referrals to the various specialists and therapists stationed at the Yorktown in those first few weeks. The sudden spike in anxiety, PTSD, and depression wasn’t unexpected, or uncommon, especially amongst the surviving Enterprise crew, and when Connors stumbled into his office complaining of headaches and difficulty focusing on his new construction job, McCoy made the seemingly obvious diagnosis and sent him on his way with a referral to meet with a therapist two times a week as needed. 

“That was until Ensign Connors came back to the hospital in a body bag four days later,” another Starfleet big whig McCoy doesn’t recognize prompts, interrupting him in the middle of his explanation. Leonard grit his teeth for a long moment before taking a deep breath, digging his fingernails into his knee.

“Yes, Commodore, that is correct. Until that point there was no reason for me to assume anything else was wrong with Ensign Connors than the usual symptoms one experiences when they survive something traumatic. I performed a brief physical, just to make sure he was meeting his general needs for food and drink, and other than a high pulse rate nothing seemed to be amiss. As the old saying goes, Commodore, when you hear hoofbeats, you don’t think zebras, especially when you’ve already seen two dozen horses that week.” 

Admiral Nogura is nodding in silent agreement but the Commodore doesn’t seem much appeased by McCoy’s explanation. 

“So, you performed the autopsy on Ensign Connors yourself, then,” he prompts, sitting back in his high seat with his arms folded huffily across his chest. His hologram fizzles for a moment before returning to its original clarity. 

McCoy had performed the autopsy all right. A difficult, miserable part of the job that he never got used to. Connors was just a kid, barely into his mid twenties, with a promising future in engineering ahead of him. Sunken, empty eyes stared accusingly up at McCoy all through the autopsy. His skin is sallow and dry, tinged blue around the mouth, and his internal organs are in even worse shape. He’d died of massive organ failure due to, if McCoy was not mistaken, severe oxygen deprivation. It was as if his body had just forgotten how to carry oxygen and McCoy could have caught this. He _should_ have caught this. 

Or at least, that’s what he thought at the time. A misdiagnosis due to laziness, a general comfortability in the steady stream of mental trauma typical symptoms, an inability to see the trees through the forest. 

“That was until the next patient came in exhibiting similar symptoms: the cognitive difficulties, frequent headaches, an uptick in the blood pressure. Another member of the Enterprise crew who had been the picture of health until then. She wasn’t alone, either. I had three patients including her with similar symptoms that day and within the week I suddenly had an entire ward of them. I figured it must be something they picked up during our stay on Altamid. Some… new fungus or bacteria that had been in the air or water, which wouldn’t be recognized by the equipment, that we just needed to find. It quickly became obvious though that if our patients were going to survive long enough for a diagnosis, we needed to figure out how to treat the worst of the symptoms. That is, to say, the body’s slowly deteriorating ability to absorb the oxygen they were breathing.”

They were able to extend the length of the early stages if the symptoms were caught in time and treated with round the clock treatment with oxygen and a restriction on physical activity. Not knowing how the disease was spread, McCoy ordered all patients presenting with symptoms of what they had then called Syndrome A to be quarantined at the hospital, and for every member of the Enterprise crew that had escaped Altamid to come in for a physical examination. 

“And this is when Commander Spock returned from a temporary posting on the USS Endeavour, along with Captain Kirk,” interrupted another member of the Tribunal, once again testing Leonard’s patience. 

“Yes, sir, that is correct. It is also at this time that people who were not members of the Enterprise crew started exhibiting the same symptoms. At first we couldn’t figure out a connection until Christine --- sorry, Christine Chapel, a nurse stationed at the Yorktown Hospital and one of the key members of my diagnosis team, realized that all of the newly infected Yorktown residents either worked in fairly close proximity to, or had recently engaged in a physical relationship with, a member of the infected Enterprise crew. It was Commander Spock who, based on this evidence, decided that the disease may in fact be viral in nature, if it was spreading based on an exchange of bodily fluids.”

McCoy took no small amount of satisfaction in the tense, uncomfortable silence those words created, even if only for a brief moment. The year is 2263 and grown adults still can’t handle a little sex talk. 

Infants. 

Deciding to show them a little undeserved mercy, McCoy moves on, folding his hands on his lap and trying to ignore the holes Jim is staring into the back of his skull. He’s vividly reminded of a similar Tribunal, though academic in nature, where the roles had been distinctly reversed. 

“Commodore Paris sent a team back to the planet of Altamid to take samples of the water and vegetation while Commander Spock and I led the investigatory team here at the Yorktown. Our progress was… stunted at best, however, and further hindered by the deaths of two more of my patients, bringing the total death toll to four. In the most advanced stages of the disease the only way to hinder its progression was to sequester the patients inside hyperbaric chambers round the clock, and even that wasn’t enough to stop the disease in its tracks. At the end, all we could do was make them as comfortable as possible. It seemed that nothing we did was getting us any closer to figuring out what was causing this illness, nevermind figuring out a cure, even as more and more people came in exhibiting the symptoms of Syndrome A,” he murmured, running his fingers through his hair. When was the last time he took a shower? He hadn’t even gotten the chance to go home and sleep before he was none so gently escorted out of the hospital and sequestered to await the Tribunal. The whole thing seemed rather rushed, as if they were desperate to just get it over with, to sweep him under the rug and pretend none of this ever happened. 

“What changed?” Rear Admiral Flor’pa asks, almost gently, twitching her eyestalks in his direction. 

What changed was Spock crumpled to the floor at his microscope one morning and didn’t get back up again. 

McCoy squeezes his eyes shut, recalling the gut wrenching panic that had consumed him when he turned just in time to see him falling. He remembers how cold Spock’s skin had been, the pale yellowish tinge of his lips and the weak flutter of his eyelids. 

Christine had called Jim to take him home after what was, in no uncertain terms, a complete and utter emotional breakdown. It didn’t help that, at that point, McCoy was constructed almost entirely out of adrenaline stims and lies to his coworkers and partners about his own self care.

Jim had poured the near-catatonic Leonard into the refresher and scrubbed weeks of suffering and stress off his skin until he was raw. He’d begged Jim to fuck him and so he had, he’d fucked Leonard into the mattress again and again, both of them desperate to feel anything except the howling uncertainty and the painful absence of Spock’s presence in their bed. Their small apartment felt somehow painfully smaller still without the quiet Vulcan meditating in the corner, or sitting at the kitchen table drinking his morning tea and silently judging them for their struggles with getting up. 

“Doctor McCoy?” 

McCoy coughs to cover the awkward silence that had fallen over the Tribunal as he went on that trip down Unpleasant Memory Lane, hazel green eyes focusing once more on Admiral Nogura. 

“Spock fell ill, Admiral. Quite suddenly and with a far more rapid deterioration than any other patient had exhibited thus far. Shortly after, Captain Kirk had also fallen ill and required hospitalization, along with half my research team and a full two thirds of the surviving Enterprise crew. All incoming and outgoing traffic from the Yorktown Star Base had been halted at this point, to reduce the risk of this epidemic becoming a multi-global pandemic. We were running low on hope when we lost another patient, an older gentleman from the Yorktown. That’s when I finally had enough data points to notice a pattern.” 

McCoy grinds his jaw through the phrase ‘data points’, however there was no other way to describe it. He’d needed more information to discern some kind of commonality, and patient deaths were, unfortunately, a prime source. 

“Of the five deaths, four had been in their later years, thus, their immune systems were not as strong as the other patients. Their organs were older and failed sooner, unable to take the strain. Additionally, the autopsy of Ensign Connors, the only victim of Syndrome A under eighty years of age, had produced some anomalous results. It turns out the kid had an undiagnosed heart defect, causing his heart to fail prematurely as the illness progressed. Furthermore, we had the curious case of Commander Spock to consider,” he explained, leaning back in his chair with a deep frown digging into the corners of his mouth. 

“Vulcans have copper based blood, as I’m sure you’re aware. So we were looking for a illness that attacked the body’s ability to absorb oxygen, only caused death in human patients with compromised immune systems and the elderly, and was particularly fast moving and potentially deadly to beings with copper blood. We finally knew where to look and, sure enough, once we got blood samples from Commander Spock under a microscope, there it was. In iron based blood samples, the virus’s appearance had mutated and blended in with the dark red of the bloodstream, but showed up plain as day in the bright green of Vulcan blood.” 

Falling silent, McCoy’s gaze drifts down to his fisted hands, watching them shake with exhaustion. When Jim had also gone to the hospital, he’d nearly lost it. The only thing keeping him together had been his desperate need to cure them, to save the only two people in his life that made it worth living. 

“So you developed a vaccine capable of curing the disease?” another Rear Admiral that McCoy doesn’t recognize asks, his thick mustache doing nothing to obscure the frown clearly on his face. 

“Using the samples the away team brought back from Altamid, Nurse Chapel and I were able to synthesize a cure to the illness. I had been curious as to how Krall and his lackeys, as well as the few refugees, like Jaylah, that had escaped him but still lived on the planet, had remained unaffected by the disease for so many years. Turns out there’s a natural antigen in the water, so they had all built up an immunity to the illness,now named Choriocytosis, through regular eating and drinking. It’s also the reason why I, having consumed the water when we landed on the planet’s surface, had retained some degree of resistance to the virus all this time, despite my… regular proximity to Commander Spock and Captain Kirk. We inoculated all of the patients and they recovered, slowly but surely. A vaccine was developed and distributed to the remaining population of the Yorktown that had not yet contracted Choriocytosis, and the outbreak was over,” McCoy states flatly, angling his chin defiantly up at the Tribunal.

He just wants to go home. 

“Is there anything you would like to add before we reach our verdict, Lieutenant Commander?” Nogura asks politely, tipping his head to the side as if to examine McCoy from another point of view. Leonard shrugs one shoulder, wondering if it even matters if he does. 

“I recommend Nurse Christine Chapel for a commendation, as well as a formal posting upon the Enterprise, should she desire it. Her talent for healing and deduction is wasted on the Yorktown, which until this point largely dealt with broken bones and other minor injuries. Doctor Geoffrey M’Benga, as well. He lead the away team to Altamid and is responsible for returning with the resources vital to manufacturing a cure. The entire research team, especially the ones that contracted the illness in the line of duty, also deserve special commendation. They went above and beyond to care for their patients and showed unwavering bravery in the face of a potentially incurable illness, and if anyone is going to be held responsible for the deaths of those patients, well, then, it should be me and me alone,” he says anyways. He can tell Nogura and the rest of the Tribunal are surprised by that. He’s sure they expected him to beg for his freedom, but Leonard likes to think he has slightly more dignity than that. 

“Very well, then. This Tribunal will adjourn for a period of thirty minutes to discuss the evidence and testimony presented.” 

Not a single person left the audience while the hologram versions of Starfleet high command flickered out of view to do just that. McCoy remained in his seat, facing forward, refusing to look at the no doubt sad, pitying faces of his friends and coworkers behind him. 

At the end of the day, he’d lost five patients. Five people who would have been alive today if only he’d been smarter, faster, better at his job. He wonders if they’ll let him catch a shuttle back to Earth once he’s stripped of his rank and title, or if he’s just going to be dumped on the nearest prison planet. 

The loud pop and flash of light as the Admiralty returns to deliver their decision startles Leonard out of his morbid day dreaming. The grim, stony faces of the people before him don’t look promising, and the bottom of his stomach drops out from under him. 

“Stand, Lieutenant Commander McCoy, to receive the verdict.”

He does as ordered, feeling numb all over. This was it. He was going to lose everything. His ship. His crew. His license to practice medicine. His life. 

Not literally, of course, Starfleet didn’t believe in the death penalty, but in a more.. Metaphorical, spiritual sense. He wouldn’t be allowed to step foot on a Starfleet vessel ever again, and he wouldn’t allow Jim or Spock to step foot _off_ a Starfleet vessel to join him in exile. 

Just because he was meant for lesser things doesn’t mean he has to drag them down with him. 

“It is the opinion of this Tribunal that Lieutenant Commander Leonard McCoy, Chief Medical Officer of the USS Enterprise, be awarded the Legion of Honor for his outstanding performance under pressure during this crisis, and for identifying this unknown virus, as well as synthesizing not only a cure but a vaccine to prevent future outbreaks. He, along with Nurse Christine Chapel and Doctor Geoffrey M’Benga, will receive the Starfleet Award of Valor, for their joint efforts in the care and treatment of their patients, and for their work in identifying and curing the disease. All charges of malpractice and wrongful death filed against Doctor McCoy are hereby dismissed, and the Lieutenant Commander is free to go,” Admiral Nogura declares, stunning the room into silence for one long second before there’s an absolute _explosion_ of noise. 

Leonard stands there staring at them blankly, taking in far more information than his sleep deprived brain wanted to in that moment. He was free to go? Not only that but he was being commended for his work? He hears the whooping, familiar cry of Chekov and Sulu as if through a long tunnel, distantly recalling their scared, wide eyes looking up at him only a few days prior, hands clutching matching oxygen masks to their faces.

He startles when something solid collides with his shoulder and it takes him a moment to realize that it’s Jim, tackling him in celebration with a far more aggressive hug than he’s capable of returning in his exhausted state. 

“You’re a damn martyr, Bones, you know that?” he complains in McCoy’s ear, squeezing him tight. “Telling them to put all the blame on you, what the actual hell.” 

Leonard grumbles under his breath about pots and kettles but allows himself to be led out of the auditorium and into the offensively bright artificial sunshine of the Yorktown. He needs a shower, a hot meal, and sleep, not necessarily in that order, and he’s willing to brave the outdoors if it means he gets any of those things sooner.

However, when they finally get back to their tiny apartment, and Leonard opens the door to see Spock seated at the table with a mug of tea, all thoughts of sleep go out the window. 

Both metaphorically and literally this time. 

“They let you leave the hospital?” he asks stupidly, face heating up when Spock turns to fix him with a look that says ‘Obviously.’

McCoy can’t even muster the energy to be annoyed though, so all consuming is his relief and delight, and he crosses the room in two quick steps to throw his arms around Spock’s shoulders, crushing his slender form against his chest. 

“I thought I was gonna lose you,” he whispers fiercely into the Vulcan’s neck, shuddering as he feels Jim sliding up beside them. He keeps one arm around Spock and reaches out with the other to pull Jim towards him, refusing to loosen his grip on either of them. 

“Both of you gave me a scare. I’m not as young as I once was, you know. You can’t keep doin’ this to me.” Leonard’s voice is thick with emotion, tired green eyes blinking back stubborn tears. He presses his forehead against Spock’s, keeping his hand buried in Jim’s blond hair to make sure he can’t pull away. Not yet. 

“I’ll endeavor not to ‘do this’ to you in the future then, Leonard,” Spock says in his familiarly bland, affectionate way, angling his head just enough to steal a whisper of a kiss from Leonard. Jim matches it with a kiss to McCoy’s temple, stroking a soothing hand down his back. 

His clinging makes it somewhat difficult for Jim and Spock to convince him to let go long enough for a shower and some actual, solid food, but they manage, even if Spock clearly does not enjoy sitting on Leonard’s lap at the dinner table as much as Leonard likes having him there. He almost lost them both, first to the disease, and then to the Tribunal. He’s not going to let them go again anytime soon, inconvenient clinging be damned.

Still, Leonard’s sleepy and pliant by the time Jim and Spock coerce him into bed, curled up between them with Jim at his back and Spock at his front, like two halves making the broken, empty mess of him whole again. And as McCoy drifts off, warm and full and content for the first time in weeks, he decides he wouldn’t trade this moment for all the awards and commendations in the whole damn universe.

**Author's Note:**

> Choriocytosis, the disease featured in this story, was in an episode of The Animated Series, but I tweaked the treatment and cure to suit my needs.
> 
> I may at some point write a follow up to this that takes slices of time during the investigation and treatment of McCoy's patients, particularly the ones he knows, because those are truly a gold mine of angst I want to explore, but I wanted to retain the in-the-moment trial/tribunal format of this story for now so I left the majority of those ideas out for now.


End file.
